TY - JOUR
T1 - Emerging new approaches for the treatment of acute promyelocytic leukemia
AU - Park, Jae
AU - Jurcic, Joseph G.
AU - Rosenblat, Todd
AU - Tallman, Martin S.
PY - 2011/10
Y1 - 2011/10
N2 - The introduction of all-trans retinoic acid (ATRA) in the late 1980s combined with anthracycline-based chemotherapy has revolutionized the prognosis of acute promyelocytic leukemia (APL) with more than 90% complete response rates and cure rates of approximately 80%. The subsequent advent of arsenic trioxide (ATO) in 1990s and progress in the treatment of APL have changed its course from a highly fatal to a highly curable disease. Despite the dramatic improvement in clinical outcome of APL, treatment failure still occurs due most often to early death. Relapse has become increasingly less frequent, most commonly occurring in patients with high-risk disease. A major focus of research for the past decade has been to develop risk-adapted and rationally targeted nonchemotherapy treatment strategies to reduce treatment-related morbidity and mortality to low- and intermediate-risk or older patients while targeting more intensive or alternative therapy to those patients at most risk of relapse. In this review, emerging new approaches to APL treatment with special emphasis on strategies to reduce early deaths, risk-adapted therapy during induction, consolidation and maintenance, as well as an overview of current and future clinical trials in APL will be discussed.
AB - The introduction of all-trans retinoic acid (ATRA) in the late 1980s combined with anthracycline-based chemotherapy has revolutionized the prognosis of acute promyelocytic leukemia (APL) with more than 90% complete response rates and cure rates of approximately 80%. The subsequent advent of arsenic trioxide (ATO) in 1990s and progress in the treatment of APL have changed its course from a highly fatal to a highly curable disease. Despite the dramatic improvement in clinical outcome of APL, treatment failure still occurs due most often to early death. Relapse has become increasingly less frequent, most commonly occurring in patients with high-risk disease. A major focus of research for the past decade has been to develop risk-adapted and rationally targeted nonchemotherapy treatment strategies to reduce treatment-related morbidity and mortality to low- and intermediate-risk or older patients while targeting more intensive or alternative therapy to those patients at most risk of relapse. In this review, emerging new approaches to APL treatment with special emphasis on strategies to reduce early deaths, risk-adapted therapy during induction, consolidation and maintenance, as well as an overview of current and future clinical trials in APL will be discussed.
KW - acute promyelocytic leukemia
UR - http://www.scopus.com/inward/record.url?scp=84993737860&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84993737860&partnerID=8YFLogxK
U2 - 10.1177/2040620711410773
DO - 10.1177/2040620711410773
M3 - Review article
C2 - 23556100
AN - SCOPUS:84993737860
SN - 2040-6207
VL - 2
SP - 335
EP - 352
JO - Therapeutic Advances in Hematology
JF - Therapeutic Advances in Hematology
IS - 5
ER -